Individual provider Active NPI

Sri Satya P Medidhi, BPT

  • Physical Therapist
  • Lafayette, LA
National Provider Identifier
1952948663
Registry record updated Dec 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP000830T Issued in LA
Practice address
325 Oil Center Dr
Lafayette, LA 70503-2419
Phone
(337) 504-5144
NPI assigned
Dec 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6811 MS
Physical Therapist 225100000X CP000830T LA Primary

Addresses

Primary practice location

325 Oil Center Dr
Lafayette, LA 70503-2419

Mailing address

325 Oil Center Dr
Lafayette, LA 70503-2419
Phone (337) 504-5144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220525001494 MD Practitioner - Physical Therapist in Private Practice 8527496413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10 Brandywine Dr
Mastic, NY 11950-1404

6202 Gist Ave
Baltimore, MD 21215-3608

9021 Balin CT
Pikesville, MD 21208-2151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP000830TLAMDPhysical Therapist
6811MSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lea'S Place LLC Physical Therapist CurrentSince Apr 26, 2022 Accepting new patients
Lynch Physical Therapy, LLC Physical Therapist CurrentSince Apr 1, 2023 Accepting new patients
Paramount Diagnostics LLC Physical Therapist PastSince Apr 1, 2023 Accepting new patients

Locations

1848 Reisterstown Rd
Ste A
Pikesville, MD 21208
Phone (410) 292-8725

485 Ritchie Hwy
Ste A202
Severna Park, MD 21146
Phone (410) 960-1601

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575244800000",
    "number": "1952948663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 OIL CENTER DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032419",
            "telephone_number": "337-504-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 OIL CENTER DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032419",
            "telephone_number": "337-504-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDIDHI",
        "first_name": "SRI SATYA",
        "middle_name": "P",
        "credential": "BPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2019-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MS",
            "license": "6811",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "CP000830T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.